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94:lv- 0-6_4/1 <br /> UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE (LEAK)/CONTAMINATION SITE REPORT <br /> EMERGENCY HAS STATE OFFICE OF EMERGENCY SERVICES FORLOCAL'AGENCY USE ONLY <br /> REPORT BEEN FILED 7 ❑ 1HERE8YCERTIFYTHAT.I HAVE DISTRIBUTED THIS INFORMATION ACCORDING TO THE <br /> [] VESNO ES NO <br /> REPORT DATE DIS RIBUTICN SHOWN ON THE INSTRUCTION SHEET ON THE BACK PAGE OF THIS FORM <br /> CASE i <br /> 5 2 9 2. N A scKEDh fie' L ( 2q `�Z <br /> DATE <br /> NAME OF INDIVIDUAL FILING REPORT PHONE SIGNATURE <br /> Berentta Wess (415) 571-2434 <br /> w <br /> REPRESENTING OWNER/OPERATOR Q <br /> REGIONAL BOARD COMPANY OR AGENCY NAME <br /> S LOCAL AGENCY Q OTHER ARCO Products Co. <br /> ADDRESS <br /> P.O. Box 5811 San Mateo, CA 94402 <br /> 9TRFET Cm STATE Mp <br /> J NAME CONTACT PERSON PHONE <br /> .It ARCO Products Co. UNKNOWN Chuck Carmel (415 )571-2469 <br /> 0 ADDRESS <br /> P.O_ Box 5811, San Mateo CA x 94402 <br /> STREET CITY STATE IP <br /> FACILITY NAME(IF APPLICABLE) OPERATOR PHONE <br /> o SS# 2168 Robert James Parkins (209 )943-0286 <br /> a ADDRESS <br /> 441 W. Charter Way, Stockton (San Joaggt n) 95206 <br /> W S REE <br /> CdIN Y <br /> y CROSS STREET ZIP <br /> @ Lincoln <br /> p LOCALAGENCY AGENCY NAME CONTACT PERSON PHONE <br /> Zw County of San Joaquin Donna Heran ( 209) 468-3420 <br /> wW REGIONAL BOARD <br /> PHONE <br /> < RWQCB - Central Valley Region John Noonan X09 )445-5116 <br /> w w Gasoline NAME <br /> QUANTITY LOST(GALLONS) <br /> aUNKNOWN <br /> m A <br /> m O UNKNOWN V <br /> Z DATE DISCOVEREDHOW DISCOVERED ED INVENTORY CONTROL O SUBSURFACE MONITORING O NUISANCE CONDITIONS ` <br /> 0 � 4 8D 9Y 2Y TANK TEST TANK REMOVAL OTHER Drilling <br /> DATE DISCHARGE DARGE BEGANIS <br /> Y UNKNOWN REMOVE CONTENTS EDCLGS(CHECK E TANKA REMOVE :NOEPAIR PIPING <br /> p RAS DISCHARGE BEEN STOPPED 7 ;SISiEPAIR TANK O CLOSE TANK d FILL IN PUCE a CHANGE PROCEDURE <br /> o YES O NO IF YES,DATE Y Y I]REPLACE TANK OTHER <br /> jD SOURCE OF DISCHARGE CAUSE(S) <br /> ¢j TANK LEAK UNKNOWN O OVERFILL RUPTURE/FAILURE O SPILL <br /> a <br /> w 0 0 PIPING LEAK O OTHER O CORROSION UNKNOWN O OTHER <br /> mi CHECKONEONLV <br /> O UNDETERMINED SOIL ONLY GROUNDWATER E3 DRINKING WATER (CHECK ONLY IF WATER WELLS HAVE ACTUALLY BEEN AFFECTED) <br /> CHECK ONE ONLY <br /> Z ❑ NO ACTION TAKEN Q PRELIMINARY SITE ASSESSMENT WORKPLAN SUBMITTED Q POLLUTION CHARACTERIZATION <br /> a <br /> LEAK BEING CONFIRMED � PRELIMINARY SITE ASSESSMENT UNDERWAY 0 POST CLEANUP MONITORING IN PROGRESS <br /> O REMEDIATION PLAN O CASE CLOSED(CLEANUP COMPLETED OR UNNECESSARY) E:] CLEANUP UNDERWAY <br /> CHECK APPROPRIATE ACTIONS) EXCAVATES DISPOSE <br /> O (ED) REMOVE FREE PRODUCT(FP) O ENHANCED BIO DEGRADATION(IT) <br /> �aiO F-1CAP SITE(CD) EXCAVATE&TREAT(ET) 0 PUMPS TREAT GROUNDWATER(GT) REPLACE SUPPLY IRS) <br /> Q CONTAINMENT BARRIER(CB) NO ACTION REQUIRED(NA) a TREATMENT AT HJOOKUP(HU) O VENT SOIL(VS) <br /> VACUUM EXTRACT(VE) !OTHER(OT)`C (i A� C,c-'Me.L146 he-eP- l rm N _ Ai:::y,nAJ <br /> rz <br /> Subsurface experation was performed to investigate location of any <br /> impacted soil 6 groundwater. ARCO notified of contamination on site <br /> 8 5-18-92 by Resna. <br /> MW O(IM) <br />